罂粟碱联合替罗非班冠脉内注射对PCI术中无复流患者心肌损伤程度的影响

摘要

Objective:To study the effect of papaverine combined with tirofiban intracoronary injection on the degree of myocardial injury in patients with no reflow during percutaneous coronary intervention (PCI) .Methods:Patients who underwent PCI in Ankang Central Hospital between March 2014 and May 2017 were retrospectively studied and divided into two groups according to the intravascular drugs they received during PCI .Combined group received papaverine combined with tirofiban intracoronary injection and control group received tirofiban intracoronary injection .The changes in myocardial injury indexes ,platelet activation indexes and inflammatory molecules were measured before PCI as well as 24 h and 48 h after PCI .Results:Serum CK-MB ,cTnI ,MYO ,IMA ,CD62p ,GPIIb/IIIa ,MIP-1α,sICAM-1 and HMGB-1 levels as well as peripheral blood Lp-PLA2 ,PAF ,P-selectin ,ERK and NF-κB fluorescence intensity of both groups 24 h and 48 h after PCI were significantly lower than those before PCI (P< 0 .05) ,and serum CK-MB ,cTnI ,MYO ,IMA ,CD62p ,GPIIb/IIIa ,MIP-1α,sI-CAM-1 and HMGB-1 levels as well as peripheral blood Lp-PLA2 ,PAF ,P-selectin ,ERK and NF-κB fluorescence intensity of combined group 24 h and 48 h after PCI were significantly lower than those of control group (P<00.5) .Conclusion:Papaverine combined with tirofiban intracoronary injection for PCI can reduce the degree of myocardial injury .%目的:研究罂粟碱联合替罗非班冠脉内注射对经皮冠状动脉介入治疗(PCI)术中无复流患者心肌损伤程度的影响.方法:选择安康市中心医院2014年3月~2017年5月期间进行PCI治疗的患者进行回顾性研究,根据PCI术中冠脉内使用药物不同分为两组,联合组使用罂粟碱联合替罗非班冠脉内注射、对照组使用替罗非班冠脉内注射.PCI术前及术后24、48 h,测定心肌损伤指标、血小板活化指标以及炎症分子的变化.结果:两组患者PCI术后24、48 h血清CK-MB、cTnI、MYO、IMA、CD62p、GPIIb/IIIa、MIP-1α、sICAM-1、HMGB-1的含量以及外周血中Lp-PLA2、PAF、P-selectin、ERK、NF-κB的荧光强度均显著低于PCI术前(P<00.5),且联合组患者PCI术后24、48 h血清中CK-MB、cTnI、MYO、IMA、CD62p、GPIIb/IIIa、MIP-1α、sICAM-1、HMGB-1的含量以及外周血中Lp-PLA2、PAF、P-selectin、ERK、N F-κB的荧光强度均显著低于对照组(P<00.5).结论:罂粟碱联合替罗非班冠脉内注射用于PCI术能够减轻心肌损伤程度.